This study investigated the effect of cannabinoid receptor 2 (CB2R) on macrophage polarization and inflammatory severity in periodontitis, elucidating CB2R’s potential role in the disease. Chronic periodontitis was induced by ligating maxillary second molars with orthodontic filaments in wild-type (WT) and CB2R knockout (CB2R-/-) mice. Unligated mice served as controls. After 3 weeks, maxillae were harvested. Micro-CT evaluated modeling success and quantified alveolar bone resorption. HE staining assessed periodontal tissue destruction. Immunohistochemistry (IHC) analyzed macrophage polarization, while RT-qPCR measured mRNA levels of macrophage markers and inflammatory cytokines. 1. Micro-CT revealed significantly greater alveolar bone resorption in both CB2R-/- and WT periodontitis groups versus controls (P < 0.05), with CB2R-/- mice exhibiting more severe resorption than WT mice.2. HE staining demonstrated increased bone loss, inflammatory infiltration, and tissue destruction in periodontitis groups, most pronounced in CB2R-/- mice.3.IHC indicated elevated M1/M2 macrophage markers in periodontitis groups. M1 marker iNOS expression was significantly higher in CB2R-/- versus WT mice (P < 0.05), while M2 marker Arg-1 showed no intergroup difference (P < 0.05)0.4.RT-qPCR confirmed upregulated macrophage markers and inflammatory cytokines in periodontitis groups, with significantly higher expression in CB2R-/- mice (P < 0.05). CB2R-/- mice also exhibited elevated M1/M2 and IL-6/IL-10 ratios versus WT mice (P < 0.05). CB2R deficiency exacerbates alveolar bone resorption and inflammatory severity in periodontitis, potentially by dysregulating macrophage M1/M2 polarization and inflammatory cytokine expression.

Objective To summarize the clinical characteristic of stroke in the plateau area with altitude of 4000 m above,and to screen the risk factors of hemorrhagic stroke.Methods The clinical data of 103 stroke patients(including 71 hemorrhagic stroke and 32 ischemic stroke)admitted to Ngari Prefecture People's Hospital of Tibet Autonomous Region from January 2017 to December 2018 were retrospectively analyzed,and the clinical characteristic of hemorrhagic stroke and ischemic stroke were compared.Univariate and multivariate Logistic regression analyses were used to screen the risk factors of hemorrhagic stroke.Results The age of hemorrhagic stroke patients was lower than that of ischemic stroke patients[(57.48±10.81)years vs.(64.03±10.96)years;t=2.836,P=0.006],and the systolic blood pressure at admission[(171.92±28.95)mm Hg vs.(141.81±23.24)mm Hg;t=5.174,P=0.000],diastolic blood pressure[(107.58±18.76)mm Hg vs.(93.44±14.94)mm Hg;t=3.757,P=0.000],hemoglobin[(189.54±28.12)g/L vs.(165.35±25.42)g/L;t=4.111,P=0.000]and total cholesterol[(4.60±0.88)mmol/L vs.(4.04±0.82)mmol/L;t=3.1 18,P=0.002]were higher than those of ischemic stroke patients.Logistic regression analysis showed that systolic blood pressure on admission(OR=1.048,95％CI:1.024-1.073;P=0.000)and hemoglobin(OR=1.043,95％CI:1.015-1.072;P=0.002)elevation were risk factors of hemorrhagic stroke.Conclusions Hemorrhagic stroke is the main type of stroke in the plateau area with altitude of 4000 m above.Patients with high systolic blood pressure on admission and hemoglobin are more likely to have hemorrhagic stroke.

2022年美国血管外科学会(SVS)发布了《颅外段颈动脉狭窄临床治疗指南》，该指南依据相关领域的循证医学证据，对临床中存在争议的5个热点问题做了详尽分析，并给出了综合性治疗建议，具有很强的实践性。本文结合相关文献对该指南进行解读，以供参考。

颈动脉狭窄是缺血性卒中的重要病因,颈动脉内膜切除术(CEA)是神经外科治疗重度颈动脉狭窄的经典术式,然而国内CEA 一般在全身麻醉下进行.本研究回顾性报道2018年4月至2021年7月天津医科大学总医院神经外科在局部麻醉下行CEA治疗的6例重度颈动脉狭窄患者的临床资料.6例患者术后随访时间的中位数为24个月(3～48个月);至末次随访,患者均未发生卒中事件,颈动脉彩色多普勒超声或CT血管成像显示术侧颈动脉血流通畅,未发生再狭窄.

Background: Intracranial aneurysms are associated with a high mortality rate in the event of a rupture and significant morbidity during subsequent treatment. Hybrid treatment approaches for vascular diseases have been incorporated into modern operating rooms as guides for surgical interventions now. The current study evaluates the feasibility and effectiveness of hybrid operating room system and its application in the surgical treatment of intracranial aneurysms.Aims: To evaluate the feasibility and effectiveness of hybrid operating room system and its application in the surgical treatment for aneurysms.Methods: 76 patients with 84 intracranial aneurysms were surgically treated in Hybrid operating room with intraoperative angiography between March 2018 and March 2021. Aneurysm clipping was performed in 76 (94.7 %) cases; Aneurysm trapping with extracranial-intracranial (EC-IC) bypass in 4 (5.3 %) cases. Patient demographics, aneurysm size, location, Hunt and Hess score, were recorded. 69 (90.8 %) patients were followed up 6-12 months post operation. Results: Intraoperative angiography demonstrated 5 (6.9%) unexpected aneurysm neck residuals leading to adjustment; 6 (8.3%) parent vessel stenosis in which 5 returned to normal after adjustment. Four giant paraclinoid aneurysms trapping with EC-IC bypass showed total successful vessel reconstruction and complete aneurysm exclusion (100%). The postoperative outcome was evaluated with the modified Rankin Scale (mRS). 53 (76.8%) patients showed good outcome (mRS 0), 11 (15.9%) showed mild neurological defect (mRS 1-2), 3 (4.3%) showed poor outcome (mRS 5), and 2 (2.9%) patients died (mRS 6, Hunt-Hess grade V before surgery). Conclusion: Hybrid operating room provides new concepts in the surgically treatment of intracranial aneurysms, especially valuable for the complex aneurysms. The combination of intraoperative imaging of angiography and clipping surgery may offer the opportunity of radical clipping and reduced complications for aneurysm patients.

Abstract Meningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical manifestations. The fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5), published in 2021, introduces major changes that advance the role of molecular diagnostics in meningiomas. To follow the revision of WHO CNS5, this expert consensus statement was formed jointly by the Group of Neuro-Oncology, Society of Neurosurgery, Chinese Medical Association together with neuropathologists and evidence-based experts. The consensus provides reference points to integrate key biomarkers into stratification and clinical decision making for meningioma patients. Registration: Practice guideline REgistration for transPAREncy (PREPARE), IPGRP-2022CN234

The objective of the study was to analyze the risk factors for worsening of the disease progression in patients with chronic subdural hematomas (CSDH) during wait-and-observation treatment regimen and conservative treatment with atorvastatin. A total of 196 patients with CSDH were recruited (98 in the atorvastatin group and 98 in the blank placebo group). Receiver operating characteristic (ROC) curve analysis was used to identify the optimal cutoff for the hematoma volume by testing surgical and nonsurgical outcomes. Other measures, including univariate and multivariate analyses, were performed to identify the potential significant factors indicative of the outcome of therapeutic efficacy of conservative treatment through the characteristics of the baseline indicators at enrollment. Over a median treatment duration of 2 months, lower total cholesterol, higher hematoma volume, and more midline shift were independent risk factors for worse outcomes of atorvastatin treatment for CSDH, and only a higher hematoma volume was an independent risk factor for spontaneous absorption in the placebo group. ROC analysis of all of the data showed that the optimal threshold of hematoma volume was 68.5 ml (sensitivity 73.5%, specificity 74%) in response to the greatest chance of switching to surgery. Critical independent predictors of atorvastatin monotherapy treatment success included higher total cholesterol, lower hematoma volume, and less midline shift in atorvastatin monotherapy, and higher hematoma volume was the only independent risk factor in close follow-up observation patients without any pharmacotherapy. Initial hematoma volume more than 68.5 ml may help clinicians to determine individual risk assessments and to make optimal treatment decisions. http://www.ClinicalTrials.gov . Identifier NCT02024373.

Objective:To investigate the effectiveness of high-flow intracranial and extracranial vascular bypass in the surgery for middle cranial fossa tumors.Methods:A retrospective analysis was conducted on the clinical data of 5 patients with middle cranial fossa tumors treated by tumor resection combined with high-flow external carotid artery-middle cerebral artery bypass from January 2014 to January 2020 in the Department of Neurosurgery of Tianjin Medical University General Hospital. Among them, 2 cases were primary tumors and 3 cases were recurrent tumors. The bridging vessel was the great saphenous vein in 2 cases and the radial artery in 3 cases. Postoperatively, the degree of tumor resection was evaluated according to the enhanced brain MRI scan, and no tumor enhancement in the surgical area was considered as total tumor resection. Imaging and telephone follow-up was performed 3 months after surgery and annually thereafter. Imaging follow-up included head MRI, digital subtraction angiography (DSA), or CT angiography (CTA). Telephone follow-up was conducted for assessment of Karnofsky performance status score (KPS) and related neurological functions.Results:All 5 patients underwent successful intracranial and extracranial revascularization of the anterior circulation. Total resection of the tumor on imaging was achieved in all 5 cases. Pathological results showed meningiomas in 4 cases and isolated fibrous tumors in 1 case. Postoperative review of cranial CTA results in all 5 patients suggested patency of the bridging vessels. Two patients with primary tumors developed postoperative damage of cranial nerve Ⅱ, Ⅲ, Ⅳ, and Ⅵ on the affected side and 1 had dysfunction of cranial nerve V; One of the 3 patients with recurrent tumors had blindness in the affected eye. The median postoperative follow-up period was 3 years (1-5 years) for all 5 patients. Neurological deficits in the cavernous sinus improved in 4 patients during follow-up. Five patients had KPS scores of 60-70 at 1 month postoperatively and 80-90 at 12 months postoperatively. By the final follow-up, none of the 5 patients showed tumor progression or recurrence; the results of repeat cranial CTA or DSA indicated patency of the bridging vessels and no significant vascular stenosis.Conclusions:Preliminary observations have revealed that the use of high-flow external carotid artery-middle cerebral artery bypass followed by tumor resection for the treatment of complex middle cranial fossa tumors could result in high rates of total tumor resection and bridging vessel patency, low rates of severe ischemic stroke events, and good overall clinical outcomes.

OBJECTIVES:The aims of this study were to evaluate the feasibility of a new rapid tumor resection technique using soft coagulation monopolar suction (SCMS) and to strengthen neurosurgeons' understanding, use, and attention to this new electrosurgical technique. METHODS:The rapid surgical resection technique used herein comprised monopolar suction in soft coagulation mode applied by the ERBE VIO 300s workstation and conventional microsurgical suction. We applied this technique to supratentorial tumors in 12 patients (5 with glioblastomas, 4 with astrocytomas, 2 with metastases, and one with lymphoma) as the SCMS group. The conventional bipolar electrocautery and suction method was used for another 12 patients (non-SCMS group). The surgical results and perioperative complications were retrospectively evaluated. Radiographic and histologic analyses were performed to describe the degree of thermal damage. RESULTS:The mean estimated operative time and total blood loss were 3.63 ± 0.61 hours (P = 0.0048) and 308.33 ± 172.99 mL (P = 0.0482) in the SCMS group, respectively, and these values were significantly lower than those in the non-SCMS group (4.33 ± 0.49 hours and 466.67 ± 196.95 mL, respectively). No significant differences in perioperative complications, Karnofsky Performance Status scores, perioperative area edema volumes, perioperative ischemic areas, or mean residual tumors were observed between the groups. Histological examination revealed that SCMS produced uniform coagulation and completely obstructed most small vessel structures on the tumor surface. CONCLUSIONS:This new technique involving SCMS allows for a smooth surgical procedure and appears to be safe and feasible for the rapid resection of supratentorial brain tumors. Thus, neurosurgeons should consider using this technique in the future.

Background: Endoplasmic reticulum (ER) stress and unfolded protein response (UPR) is associated with neuroinflammation and subsequent cell death following traumatic brain injury (TBI). The sigma-1 receptor (Sig-1R) acts as a dynamic pluripotent modulator of fundamental cellular processes at the mitochondria-associated membranes (MAMs). The activation of Sig-1R is neuroprotective in a variety of central nervous system diseases, but its impact on ER stress induced by traumatic brain injury is not known. This study investigated the role of Sig-1R in regulating the ER stress-mediated microglial activation and programmed cell death (apoptosis and pyroptosis) induced by TBI. Methods: Ten human brain tissues were obtained from The Tianjin Medical University General Hospital. Four normal brain tissues were obtained from patients who underwent surgery for cerebral vascular malformation, through which peripheral brain tissues were isolated. Six severe TBI tissues were from patients with brain injury caused by accidents. None of the patients had any other known neurological disorders. Mice with Sig-1R deletion using CRISPR technology were subjected to controlled cortical impact-induced injury. In parallel, wild type C57BL/6J mice were analyzed for outcomes after they were exposed to TBI and received the Sig-1R agonist PRE-084 (10 mg/kg daily for three days) either alone or in combination with the Sig-1R antagonist BD-1047 (10 mg/kg). Results: The expression of Sig-1R and the 78 kDa glucose-regulated protein, a known UPR marker, were significantly elevated in the injured cerebral tissues from TBI patients and mice subjected to TBI. PRE-084 improved neurological function, restored the cerebral cortical perfusion, and ameliorated and brain edema in C57BL/6J mice subjected to TBI by reducing endoplasmic reticulum stress-mediated apoptosis, pyroptosis, and microglia activation. The effect of PRE-084 was abolished in mice receiving Sig-1R antagonist BD-1047. Conclusions: ER stress and UPR were upregulated in TBI patients and mice subjected to TBI. Sig-1R activation by the exogenous activator PRE-084 attenuated microglial cells activation, reduced ER stress-associated programmed cell death, and restored cerebrovascular and neurological function in TBI mice.

Objective:To investigate the therapeutic effect and prognostic factors of optic nerve decompression via ethmoid sphenoid approach in traumatic optic neuropathy (TON).Methods:A total of 49 patients with TON in Neurosurgery Department of Tianjin Medical University General Hospital from January 2008 to December 2019 were retrospectively analyzed. Based on the postoperative visual acuity recovery and related complications, the clinical efficacy of ethmoid sphenoidal approach for optic nerve decompression was evaluated, and the factors affecting the prognosis were analyzed.Results:All 49 patients were treated with the decompression of optic nerve tube through sieve butterfly approach, and there’s no serious complications after surgery. The total effective rate was 53.1%. Through single factor analysis, it was found that optical preoperative visual response, trauma to surgical interval are closely related to postoperative vision improvement (P=0.011, 0.016). The age, consciousness, degree of optic nerve canal fracture, different surgical approaches and CSF leakage were not significantly correlated with prognosis.Conclusion:The visual acuity of patients with TON can be improved by optic nerve decompression through ethmoid sphenoidal approach, and the patients with preoperative light perception and early post-trauma surgery may obtain better treatment effect after operation.

颅内动脉瘤(IAs)是危害中老年健康的一种常见脑血管病,降低其破裂的手术干预方式是开颅夹闭和介入栓塞.但这两种治疗方式一旦出现术后并发症,将会严重影响病人的预后.近年来国内外研究表明,内皮祖细胞(EPCs)缺陷所致的血管修复能力下降是IAs破裂的主要诱因.笔者所在的课题组发现,EPCs来源的外泌体(EPCs-Exos)可有效地降低IAs的破裂,但其作用机制尚不明确.本综述旨在探讨EPCs-Exos降低颅内动脉瘤破裂的可能机制,并基于相关理论提出外泌体以及miRNA治疗未破裂颅内动脉瘤的新策略,为临床转化提供理论参考.

Objective:To explore the treatment efficacy of common carotid-subclavian artery (SA) bypass in the patients with cerebral ischemia resulting from SA occlusion.Methods:This study enrolled 11 SA-occlusion patients who underwent common carotid artery-subclavian artery bypass in the hybrid operating room at the Department of Neurosurgery, General Hospital of Tianjin Medical University from January 2015 to June 2020. All patients had symptoms of cerebral ischemia. A retrospective analysis was conducted on the clinical effect on those patients and surgical-related complications.Results:All patients underwent successful operation. Intraoperative ultrasound and digital subtraction angiography (DSA) indicated that the vertebral artery steal syndrome disappeared and the anastomoses were unobstructed. Two patients had lymphatic rupture when SA was dissected during the operation. None of the patients had nerve damage or stroke. At 1-year follow-up, the symptoms of SA steal syndrome were significantly improved or disappeared in all patients. The systolic pressure difference of the upper limbs decreased from 27.6±9.7 mmHg before operation to 7.3±1.9 mmHg after operation ( P<0.01, 1 mmHg=0.133 kPa), and the ratio of systolic blood pressure of the patient on the affected side to that on the uninfected side increased from 0.55±0.11 before operation to 0.86±0.30 ( P<0.01). All patients had no obvious stenosis of artificial blood vessels or anastomoses, no limb ischemia or cerebral ischemia on the affected side. Conclusion:Common carotid-SA bypass is a safe and effective treatment for cerebral ischemia caused by SA occlusion.

Background Chronic subdural haematoma (CSDH) is a common condition in the elderly that often requires neurosurgical management. For small CSDH, evidence has emerged that statins may reduce haematoma volume and improve outcomes, presumably by reducing local inflammation and promoting vascular repair. We wish to extend this evidence in a study that aims to determine the efficacy and safety of atorvastatin combined with low-dose dexamethasone in patients with CSDH. Methods The second ATorvastatin On Chronic subdural Hematoma (ATOCH-II) study is a multi-centre, randomized, placebo-controlled, double-blind trial which aims to enrol 240 adult patients with a conservative therapeutic indication for CSDH, randomly allocated to standard treatment with atorvastatin 20 mg combined with low-dose dexamethasone (or matching placebos) daily for 28 days, and with 152 days of follow-up. The primary outcome is a composite good outcome defined by any reduction from baseline in haematoma volume and survival free of surgery at 28 days. Secondary outcomes include functional outcome on the modified Rankin scale (mRS) and modified Barthel Index at 28 days, surgical transition and reduction in haematoma volumes at 14, 28 and 90 days. Discussion This multi-centre clinical trial aims to provide high-quality evidence on the efficacy and safety of the combined treatment of atorvastatin and low-dose dexamethasone to reduce inflammation and enhance angiogenesis in CSDH. Trial registration ChiCTR, ChiCTR1900021659 . Registered on 3 March 2019, http://www.chictr.org.cn/showproj.aspx?proj=36157 .

听神经瘤又称前庭神经鞘瘤,是颅内常见良性肿瘤.随着神经影像的进步,显微镜、术中电生理监测的应用以及手术技术的提高,手术效果得到不断改善[1].目前对于听神经瘤治疗的要求,已经不仅仅是尽可能全切除肿瘤,而是要同时更好地保留面神经和耳蜗神经功能.因此,手术医生为保留面神经和耳蜗神经,会常常纠结肿瘤切除程度,甚至提出了手术中要心中有"膜"的虚无理论.那么,听神经瘤到底有无包膜,其包膜结构到底是什么,在切除听神经瘤时如何处理包膜,当肿瘤与面神经或耳蜗神经粘连紧密时,残留部分肿瘤组织以保留神经功能是否合理,这些问题的解决都需要相应的理论支持.

Objective:To investigate the clinical application of percutaneous balloon compression (PBC) assisted by a neurosurgical navigation and positioning planning system (referred to as robot) for the treatment of trigeminal neuralgia.Methods:A retrospective analysis was conducted on the clinical data of 13 patients with trigeminal neuralgia treated with robot-assisted PBC at the Department of Neurosurgery, General Hospital of Tianjin Medical University from March 2020 to November 2020. Preoperatively, all subjects underwent computed tomography (CT) and three-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA). The surgical navigation and positioning planning system was used for multimodal image fusion and 3D reconstruction, loading of preoperative plan, and PBC surgery. The VAS (visual analogue scale) was used to assess the patient′s severity of pain before and after surgery, and the outcome was followed up at 1 month, 3 months and 6 months after surgery.Results:All 13 patients underwent robot-assisted PBC successfully and achieved immediate postoperative relief of trigeminal neuralgia. Their median VAS scores decreased from 10 (9-10) to 0. None of the patients experienced complications such as vascular injury, diplopia, ulcerative keratitis, and infection, while all reported postoperative numbness on the ipsilateral face. Two patients showed relief of facial numbness at 3-month follow-up. One patient presented with masticatory weakness on the surgical side at 1 month post operation, which was relieved at 6-month follow-up. At the final follow-up, the VAS score remained 0 in 13 patients, and there was no recurrence of pain in any of the patients.Conclusion:Robot-assisted PBC surgery relies on navigation and robotic arm guidance for precise puncture of the foramen ovale and accurate placement of the balloon, which help improve the safety of surgery and reduce postoperative complications. Short-term follow-up reveals satisfactory results.

The goal of vestibular schwannoma treatment has gradually evolved from simple resection of the tumor and reduction of mortality and disability to the preservation of neurological function and improvement of quality of life. How to maximize the benefit of patients has become the challenge and responsibility of modern neurosurgeons. In this article, we review the literature and focus on the surgical techniques for intraoperative facial nerve protection in vestibular schwannoma, summarize the changes in surgical strategies for vestibular schwannoma in recent years, and look forward to the treatment trends.

The sigma-1 receptor (Sig-1R) is a chaperone receptor that primarily resides at the mitochondria-associated endoplasmic reticulum (ER) membrane (MAM) and acts as a dynamic pluripotent modulator regulating cellular pathophysiological processes. Multiple pharmacological studies have confirmed the beneficial effects of Sig-1R activation on cellular calcium homeostasis, excitotoxicity modulation, reactive oxygen species (ROS) clearance, and the structural and functional stability of the ER, mitochondria, and MAM. The Sig-1R is expressed broadly in cells of the central nervous system (CNS) and has been reported to be involved in various neurological disorders. Traumatic brain injury (TBI)-induced secondary injury involves complex and interrelated pathophysiological processes such as cellular apoptosis, glutamate excitotoxicity, inflammatory responses, endoplasmic reticulum stress, oxidative stress, and mitochondrial dysfunction. Thus, given the pluripotent modulation of the Sig-1R in diverse neurological disorders, we hypothesized that the Sig-1R may affect a series of pathophysiology after TBI. This review summarizes the current knowledge of the Sig-1R, its mechanistic role in various pathophysiological processes of multiple CNS diseases, and its potential therapeutic role in TBI.

There are landmarks on the course of the anterior choroidal artery (AChoA), such as the original point (OP) and the plexal point (PP), as documented in previous articles. In these previous articles, the AChoA was the terminal branch of the internal carotid artery (ICA), which had two segments throughout its course. The first cisternal segment began from the origin and ended at the point where the artery reached the choroidal fissure (the PP). The second segment consisted of one or more branches, which passed through the choroidal fissure and entered the choroid plexus. However, we found another angiographic landmark, named the most external point (MEP), along the course of the AChoA in the anteroposterior (AP) view. There was a sharp turn at the outermost limit of the course of the AChoA, and then the AChoA progressed inward and upward. We defined the outermost limit as the MEP of the AChoA. This study describes two rare cases of distal AChoA aneurysms associated with arteriovenous malformation (AVM) and Moyamoya disease that developed intraventricular hemorrhage, and we used the parent artery occlusion (PAO) technique to embolize the distal AChoA lesions at the MEP. The patients recovered well without any neurological complications.

Background: ew drugs were confirmed to be effective in the treatments of neurological dysfunction caused by acute intracerebral hemorrhage (ICH). The present prospective clinical trial aims to evaluate the effect of mouse nerve growth factor (mNGF) on neurological function in patients with acute ICH. Methods: 60 patients with acute spontaneous ICH were randomized to receive mNGF (mNGF group) and citicoline (control group) for 4 weeks within 24-72 h after onset, respectively. The primary outcome was difference in the neurological functional outcome at 3 months by the modified Rankin Scale score (mRS). The secondary outcomes were the changes in hematoma volume at 4 weeks and 3 months. Results: There were 55 patients receiving treatment (29 patients in the mNGF group, 26 patients in the control group). Among the patients, 46 patients finished the trial at 3 months; the odds of a shift towards death or dependence (mRS > 3) at 3 months in the mNGF group were lower than that in the control group with adjustment for age, sex, NIHSS at admission, and hematoma volume at admission (adjusted OR, 0.185; 95%CI, 0.059-0.582; P = 0.0039). The hematoma was gradually reduced in all 46 patients and absorbed after nonsurgical treatment at 3 months. There was no significant difference in hematoma volume between the two groups. No serious adverse event was found. Conclusions: The administration of mNGF and citicoline was well-tolerated in patients with acute ICH. mNGF was associated with improved neurological function and less disability in patients with ICH. Therefore, the quality of life of patients with ICH may be improved by mNGF.